Medicaid eligibility is the focus of most long-term care planning, but Medicaid is not the only potential source of payment. Other possible sources for long-term care coverage include:

 

First, Medicare coverage requires prior hospitalization for three or more consecutive days, not including the day of discharge.  Many elderly in need of long-term care for dementia-related problems will not first need to be hospitalized in an acute-care facility.

 

Second, Medicare coverage is not truly "long-term," since benefits are available for a maximum of 100 days of care.  Even during that period Medicare will pay the full cost of care only for the first 20 days. For the next 80 days the patient is responsible for a daily co-pay, with Medicare covering only the balance.  After 100 days, the patient has to pay the entire cost.

 

Third, Medicare covers only skilled-nursing care provided during this 100-day period.  As a result, many residents in a long-term care facility will not be eligible for Medicare for any period, since their needs can be met with custodial care.

Long-Term Care (Nursing Home) Insurance -- Long-term care insurance is becoming an increasingly popular option for persons whose assets are substantial enough to make it unlikely that they will ever become eligible for Medicaid, and for those who fear the limited quality of care that a government-provided program such as Medicaid will likely pay for in the future. (See the section on long-term care insurance below.)